Clinical impact, safety, and efficacy of single- versus Dual-Coil ICD leads in MADIT-CRT

Valentina Kutyifa, Anne Christine Huth Ruwald, Mehmet K. Aktas, Christian Jons, Scott McNitt, Bronislava Polonsky, Laszlo Geller, Bela Merkely, Arthur J. Moss, Wojciech Zareba, Poul Erik Bloch Thomsen

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Single- versus Dual-Coil ICD Leads Background Current data on efficacy, safety and impact on clinical outcome of single- versus dual-coil implantable cardioverter-defibrillator (ICD) leads are limited and contradictory. Methods Defibrillation threshold (DFT) at implantation and first shock efficacy were compared in patients implanted with single- versus dual-coil ICD leads in MADIT-CRT. The risk for atrial tachyarrhythmias and all-cause mortality were evaluated. Short- (< 30 days after the implantation) and long-term (throughout the entire study duration) complications were assessed. Results Patients with dual-coil ICD leads had significantly lower DFTs compared to patients with single-coil ICD leads (17.6 ± 5.8 J vs 19.4 ± 6.1 J, P < 0.001). First shock efficacy was similar among patients with dual and single-coil ICD leads (89.6% vs 92.3%, P = 1.00). When comparing patients with dual versus single-coil ICD leads, there was no difference in the risk of atrial tachyarrhythmias (HR = 1.57, 95% CI: 0.81-3.02, P = 0.18), or in the risk of all-cause mortality (HR = 1.10, 95% CI: 0.58-2.07, P = 0.77). Patients implanted with single- or dual-coil ICD lead had similar short and long-term complication rates (short-term HR = 0.96, 95% CI: 0.56-1.65, P = 0.88, long-term procedure-related HR = 0.99, 95% CI: 0.62-1.59, P = 1.00, long-term ICD lead related: HR = 1.2, 95% CI: 0.5-2.9, P = 0.68) during the mean follow-up of 3.3 years. Conclusions Patients with single-coil ICD leads have slightly higher DFTs compared to those with dual-coil leads, but the efficacy, safety, and clinical impact on atrial tachyarrhythmias, and mortality is similar. Implantation of single-coil ICD leads may be favorable in most patients.

Original languageEnglish
Pages (from-to)1246-1252
Number of pages7
JournalJournal of Cardiovascular Electrophysiology
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 1 2013

Keywords

  • MADIT-CRT mortality
  • atrial arrhythmias
  • heart failure
  • implantable cardioverter defibrillators

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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  • Cite this

    Kutyifa, V., Huth Ruwald, A. C., Aktas, M. K., Jons, C., McNitt, S., Polonsky, B., Geller, L., Merkely, B., Moss, A. J., Zareba, W., & Bloch Thomsen, P. E. (2013). Clinical impact, safety, and efficacy of single- versus Dual-Coil ICD leads in MADIT-CRT. Journal of Cardiovascular Electrophysiology, 24(11), 1246-1252. https://doi.org/10.1111/jce.12219